Myopia Control in Children

Introduction

Myopia, or nearsightedness, is a common vision condition where distant objects appear blurry. However, recent years have seen a troubling rise in myopia rates, particularly among children. This condition can not only impact a child’s daily activities but also increase their risk of developing sight-threatening complications later in life.

The good news is that early intervention can make a significant difference. Myopia Control Clinics offer specialized programs designed to slow or halt the progression of myopia in children. By addressing myopia early on, these programs aim to safeguard children’s vision for the future.

What is Myopia?

Myopia, also known as nearsightedness, is a common vision condition that affects how you focus light. In a healthy eye, light rays entering the eye are bent by the cornea and lens, focusing them precisely onto the retina at the back of the eye. This creates a clear image on the retina that’s then sent to the brain for processing.

With myopia, however, the eyeball is either too long or the cornea is too curved. This shape throws off the focusing process, causing light rays to converge in front of the retina instead of directly on it. As a result, distant objects appear blurry, while close objects remain clear.

myopia

The exact cause of myopia isn’t fully understood, but it’s likely a combination of genetic and environmental factors.

  • Genetics: Studies show a strong link between myopia and family history. If one or both parents have myopia, a child is more likely to develop it as well.
  • Environment: Increased near work activities like reading or excessive screen time have been linked to myopia development, particularly in children. Conversely, spending more time outdoors seems to have a protective effect.

Factors Contributing to Myopia Progression

While the exact cause of myopia remains under investigation, several factors contribute to its progression, particularly in children.

1. Time spent outdoors vs. time spent on screens

Research suggests a significant link between limited outdoor time and an increased risk of myopia development. Sunlight exposure seems to play a protective role in eye health, while excessive near work activities like reading or spending too much time on screens can put strain on the focusing muscles within the eye. This prolonged near work is believed to potentially contribute to the elongation of the eyeball, a key factor in myopia progression.

2. Excessive screen time and near work on eye health

The rise of digital devices has brought about growing concerns regarding their impact on children’s vision. Excessive screen time can lead to digital eye strain, characterized by symptoms like blurred vision, dry eyes, and headaches. While not directly causing myopia, this strain can contribute to a preference for near vision, potentially accelerating myopic progression.

3. Genetic predisposition

The Genetics of Myopia: Genetics play a significant role in myopia. A child with one myopic parent has a higher risk of developing the condition, and this risk increases further with two myopic parents. While genetics can’t be controlled, understanding your family history can help with early detection and intervention.

Recommendations for prevention

Fortunately, there are steps you can take to promote healthy vision habits and potentially slow myopia progression:

  • Encouraging more time outside in natural sunlight: Encourage children to spend more time engaged in outdoor activities. Sunlight exposure seems to have a protective effect against myopia development.
  • Taking regular breaks from screens and near work: Limit screen time for children and incorporate regular breaks to allow their eyes to relax.
  • The 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds.
  • Develop Healthy Visual Habits: Encourage good posture while reading or using screens, maintain proper lighting, and ensure children hold reading materials at an appropriate distance.
  • Regular Eye Care: Schedule regular eye exams for children, especially if there’s a family history of myopia. Early detection allows for timely intervention and management of myopia progression.

Myopia Control Treatment Methods

Beyond preventive measures, there are several treatment methods available to help control myopia progression in children. Here’s a closer look at some of the most common options:

Spectacle therapy with specialized lenses can play a role in myopia control. These lenses are designed to manipulate how light enters the eye, potentially slowing down the elongation of the eyeball.

MiyoSmart Lenses by Hoya

MiyoSmart Lenses by Hoya

  • Technology: MiyoSmart lenses incorporate Defocus Incorporated Multiple Segments (D.I.M.S.) technology. These tiny segments within the lens create a central clear zone for sharp vision and a peripheral zone with a slight blur. This peripheral blur is thought to signal the eye to reduce its axial elongation.
  • Benefits and Effectiveness: Studies have shown promising results with MiyoSmart lenses in slowing myopia progression by an average of 60%.
  • Clinical Studies: A 2-year randomized clinical trial involving 183 Chinese children aged 8-13 with myopia between -1.00D and -5.00D found that the MiYOSMART lens provided a 59% reduction in myopia progression measured by cycloplegic spherical equivalent refraction and a 60% reduction in axial length elongation compared to single vision lenses [Source: Miyosmart spectacle performance].

MyoCare Lenses by Zeiss

  • Technology: MyoCare lenses utilize DualZone technology. Similar to MiyoSmart lenses, they have a central clear zone and a peripheral zone with a slight defocus.
  • Benefits and Effectiveness: Research suggests MyoCare lenses can be effective in slowing myopia progression, with studies showing an average reduction of around 59%.

Clinical Studies: In a 12-month multi-center trial in China involving 240 children aged 6-13 with myopia between -0.75D and -5.00D, ZEISS MyoCare lenses slowed myopia progression by an average of 0.31D and axial elongation by 0.13 mm compared to single vision lenses, a relative efficacy of 48% and 41% respectively [Source: Zeiss data on Myocare efficacy 2024].

MyoCare Lenses by Zeiss

Ortho-K involves wearing specially designed rigid gas permeable contact lenses overnight. These lenses gently reshape the cornea while you sleep, providing clear vision throughout the day without the need for daytime glasses or contacts.

  • How it Works: Ortho-K lenses apply gentle pressure to flatten the central cornea, temporarily correcting nearsightedness. The reshaping effect typically lasts for 24-48 hours.
  • Benefits in Myopia Control: Studies suggest Ortho-K can effectively slow myopia progression in children.
  • Safety, Effectiveness, and Clinical Studies: Ortho-K is considered a safe and effective treatment for myopia control when properly fitted and cared for by an eye care professional. Numerous clinical trials have shown its effectiveness in slowing myopia progression.

While traditional soft contact lenses primarily correct vision, newer designs incorporate specific features to potentially slow myopia progression.

  • MiSight Lenses by CooperVision:
    • Technology: MiSight lenses utilize a concentric zone design with alternating clear and concentric rings. This design is thought to manage peripheral defocus, potentially impacting myopia progression.
    • Benefits and Effectiveness: Studies have shown MiSight lenses to be effective in slowing myopia progression in children, with an average reduction of around 59%.
    • Clinical Studies: A 3-year clinical trial demonstrated a significant decrease in myopia progression in children wearing MiSight lenses compared to single vision lenses [Source: The MiSight 1 day clinical trial]

Atropine eye drops have been used for many years to dilate the pupil during eye exams. Recent research suggests that low-dose atropine drops can be a safe and effective method for myopia control.

  • How it Works: Atropine works by relaxing the focusing muscle within the eye, which may influence the eye’s growth pattern and potentially slow myopia progression.
  • Concentration Matters: Higher concentrations of atropine can cause significant side effects like light sensitivity. However, low-dose atropine (0.01% – 0.05%) has been shown to be effective with minimal side effects.
  • Clinical Evidence for 0.05% Atropine: Extensive research supports the use of 0.05% atropine for myopia control. Studies have shown significant reductions in myopia progression, ranging from 50% to 70% [Source: American Optometric Association].

Benefits: Low-dose atropine is a safe and effective option for myopia control, with minimal side effects at the recommended concentration.

It’s important to note that choosing the most suitable treatment method depends on your child’s individual needs and preferences. Consulting with an eye care professional experienced in myopia control is crucial to determine the best course of action for your child’s vision.

Monitoring and Follow-up

Once a myopia control treatment plan is established, regular follow-up appointments are essential for monitoring its effectiveness and tracking your child’s eye health. These visits allow your eye doctor to assess any changes in your child’s vision and make adjustments to the treatment plan if necessary.

Why Regular Follow-Ups Matter

Myopia progression can vary significantly from child to child. Regular checkups allow for early detection of any potential issues and ensure the chosen treatment plan remains effective in slowing down myopia progression.

Equipment and techniques

Eye care professionals use various tools and techniques to assess your child’s eye health and track myopia progression. Some of the most common methods include:

  • Autorefraction and Retinoscopy: These tests measure the focusing power of the eye, providing valuable information about your child’s refractive error (nearsightedness, farsightedness, or astigmatism).
  • Ocular Biometry: This advanced technology uses light waves to measure the length of the eyeball. Since eyeball elongation is a key factor in myopia progression, monitoring this dimension is crucial.
  • Slit Lamp Examination: This examination allows the doctor to examine the health of the eye’s structures, including the cornea, lens, and retina.

Frequency of Follow-Up Visits

The frequency of follow-up appointments will depend on the specific treatment method used and your child’s individual needs. Generally, visits can be expected:

  • Every 3-6 months during the initial stages of treatment, particularly for younger children or those with rapidly progressing myopia.
  • Every 6-12 months once the treatment plan seems to be effectively controlling progression.

What to Expect During Follow-Up Visits

During these visits, you can expect:

  • Vision Testing: Your child’s visual acuity will be assessed to determine if their vision has changed.
  • Refractive Error Measurement: Tests like autorefraction or retinoscopy will be performed to measure any changes in your child’s prescription.
  • Eye Health Examination: The doctor will examine the eye’s structures using a slit lamp to ensure overall eye health.
  • Discussion and Adjustments: The doctor will discuss the findings, assess the effectiveness of the treatment plan, and make adjustments if needed. This might involve modifying spectacle lens design, changing contact lens parameters, or adjusting the dosage of atropine drops.

Open communication with your eye care professional is vital. Don’t hesitate to ask questions or voice any concerns you may have about your child’s vision or the treatment plan. By working together, you can ensure your child receives the best possible care for their myopia and safeguard their vision for the future.

Final Thoughts

Myopia, or nearsightedness, is a growing concern for children. The Myopia Control Clinic offers a comprehensive approach to managing and slowing the progression of myopia, protecting your child’s vision for the future.

Our Approach:

We at 360 Eyecare use a range of evidence-based treatment methods, including:

  • Specially designed spectacle lenses like MiyoSmart or MyoCare lenses
  • Orthokeratology (Ortho-K) lenses for overnight vision correction
  • Soft contact lenses designed for myopia control, such as MiSight lenses
  • Low-dose atropine eye drops for safe and effective progression control

Regular follow-up appointments are crucial to monitor progress and ensure the chosen treatment remains effective.

We understand the importance of your child’s vision.  If you’re concerned about myopia or have questions about myopia control options, we encourage you to schedule an appointment.

Taking Action:

Protect your child’s vision for a lifetime of clear sight. Contact our Myopia Control Clinic today at Beaches: 416-698-3937, Rosedale: 416-901-2725 to schedule an appointment or visit our Beaches Optometry at 2199 Queen Street East, Toronto, ON  M4E 1E5 or our Rosedale Optometry at 120 Bloor Street East, Unit 100B, Toronto, ON  M4W 1B7.

Remember, early intervention is important. Together, we can ensure your child’s eyes stay focused on a bright future.

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